vrijdag 20 oktober 2017

The prevalence of inflammatory bowel disease, that is Crohn's disease and ulcerative colitis, has increased over two to three generations in high-income countries, but in only one generation (the past 25 years) in much of the newly industrialised and "developing" world. In China, for example, these conditions have changed from being rare to common and now account for the use of as much as a quarter of gastroenterological and colorectal surgical hospital beds.1 These diseases are not necessarily less severe initially; in developing countries inflammatory bowel disease has as severe a phenotype, with the same complications, morbidity, and mortality as in established patient populations in high-income countries.

I am writing from Cox's Bazar, Bangladesh, where a large number of Rohingya have taken refuge and where our organisation, Médecins Sans Frontières, has been providing emergency medical assistance. I am working as the medical emergency manager in Kutupolong, a makeshift settlement in the Cox's Bazar district, which borders Myanmar. Of the estimated 1·2 million people in the peninsula that connects with Myanmar, only 250 000 of them are local Bangladeshi. The rest are forcibly displaced Myanmar nationals, and refugees from prior to 1992, who have been fleeing here since the 1990s.

As political leaders prepare for the third UN High-level Meeting on Non-communicable Diseases (NCDs) in 2018, the World Heart Federation (WHF) is bringing together a global coalition of international, regional, and national stakeholders in cardiovascular diseases (CVDs) to drive the urgent action needed to combat heart disease and stroke.

The 2013–16 Ebola virus disease outbreak in west Africa was associated with unprecedented challenges in the provision of care to patients with Ebola virus disease, including absence of pre-existing isolation and treatment facilities, patients' reluctance to present for medical care, and limitations in the provision of supportive medical care. Case fatality rates in west Africa were initially greater than 70%, but decreased with improvements in supportive care. To inform optimal care in a future outbreak of Ebola virus disease, we employed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology to develop evidence-based guidelines for the delivery of supportive care to patients admitted to Ebola treatment units.

Pollution is the largest environmental cause of disease and premature death in the world today. Diseases caused by pollution were responsible for an estimated 9 million premature deaths in 2015—16% of all deaths worldwide—three times more deaths than from AIDS, tuberculosis, and malaria combined and 15 times more than from all wars and other forms of violence. In the most severely affected countries, pollution-related disease is responsible for more than one death in four.

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